CLINICAL RESEARCH POSTER PRESENTATION ABSTRACTS
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Salons 10-12.
FRIDAY, 10:15-11:00 AM
Stange R.
Fasting therapy improves insulin resistance (HOMA-IR)
in patients with the metabolic syndrome.
Department for Natural Medicine—Charité
Universitaetsmedizin Berlin r.stange@immanuel.de
OBJECTIVE: Insulin resistance is considered
the pathophysiological clue to the metabolic syndrome which accounts
for the majority of severe cardiovascular complications. It also represents
a serious obstacle in the management of diabetes mellitus. Elements
of the metabolic syndrome like hypertension, hyperlipidemia or diabetes
mellitus 2 may achieve mid- to long-term (appr. months to one year)
improvement after the traditional naturopathic therapy of fasting. On
the other hand, insulin resistance can now easily be measured by the
HOMA-IR concept (Homeostasis Model Assessment for Insulin Resistance),
which is in good correlation to the gold standard of the glucose clamp.
Search for data on the effects of a fasting therapy on HOMA-IR yielded
no results. We therefore decided to explore possible effects of the
fasting therapy on HOMA-IR.
METHODS: In an open-label study, we examined
in-patients with the metabolic syndrome (according to a slightly aggravated
form of the WHO definition) and insulin resistance (HOMA-IR at baseline
> 2.0 in absence of hypoglycaemic drugs), who underwent a medically
supervised fasting therapy (Buchinger method) for at least 8 days. HOMA-IR
was measured before, at the end of therapy, and 2 months after dismissal.
RESULTS: 8 patients completed the study (4 females,
mean age 57.5 y [40-72], BMI 37.8 kg/m2 [29.7-47.6]). HOMA-IR decreased
from a mean of 4.6 (no dimension) [2.1-10.2] to 2.5 [0.6-7.2] immediately
after fasting period and to 3.1 [2.1-3.5] at follow-up, both times significantly
lower as compared to baseline. Fasting patients reported only well-known
adverse events like initial headaches and hypotension. This was in no
case reason for discontinuation.
DISCUSSION: In an open-label study, patients
with the metabolic syndrome achieved a mid-term improvement of their
elevated HOMA-IR by a medically supervised fasting therapy. Only a slight
rebound was observed after two months, encouraging studies with longer
observational period. Future studies should also focus on the endocrinological
basis of this effect, as "switch-effects" have often been
claimed. On the other hand, improvements of HOMA-IR are predominantly
attributed to drugs such as metformin or insulin-sensitizers of the
glitazone-type, and could thus easily be compared.
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